A 49-Year-Old Man Comes to the Office Due to Dysuria

A 49-year-old man comes to the office due to dysuria and hematuria.  Vital signs are within normal limits and physical examination is unremarkable; urinalysis shows gross hematuria but is otherwise normal.  The physician discusses potential causes and the need for a cystoscopy.  The patient is told what to expect during the procedure and is given written information and a referral list with instructions on how to schedule an appointment with a urologist.  He anxiously glances over the papers, saying he will make an appointment soon.  Office staff had informed the physician that the patient was unable to follow the directions on the sign-in sheet and declined to fill out paperwork.  Which of the following physician responses is the most appropriate at this time?

A) "I'd like to ask you some questions about your background; could you tell me how far you got in school?"
B) "I'm concerned about your ability to read and fill out forms; have you always had trouble with this?"
C) "Sometimes patients have difficulty making appointments; could you please read the instructions out loud?"
D) "The forms you get before an appointment help me do a thorough evaluation; could you fill them out next time?"
E) "We've discussed a lot of information today; how confident are you with scheduling an appointment for yourself?"

Correct Answer:

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